Amish Country

On my way to clinic, I pass one or two horse-drawn buggies with shrowded figures, clutched together for warmth against the blistering winter wind. House after house on the right and left stand simple yet unique on quaint farms, curtains drawn neatly to either side of each window. Clotheslines of color-coded laundry blow cautiously in the blustery breeze. Bonnet-covered children run across the farmyard to get inside of their homes, warmed by the heat of wood stoves. One man, face replete with a beard that brims his face, tows a wheel barrow to his strongly-constructed barn. A miniature version of this stoic figure trails importantly behind him with the same sky blue shirt and suspenders. As I arrive at the rural clinic, set against the snowy landscape of endless fields and farms, one family is tying their horses to the hitching post in front of the office. I am in Amish country.

I have always been intrigued by the Amish and had the privilege of growing up near one community through visits to my grandparents. Though people in this area complain of dodging horse excrement on county roads and cultural differences, I have found this community of Amish people to be altogether warm and caring. Most if not all Amish families are uninsured and rely heavily on my preceptor (a family doc) to provide a reasonable office fee, pharmaceutical samples, and good care. Though set apart by abstinence from electricity and participation in certain amenities and structure of modern America, many Amish still choose to rely on local resources, such as this "country doctor" for health care.

I have been impressed by the way that the Amish care for their own. A sick man rarely comes to clinic without his wife present in support, a child without both parents, or an elderly individual in the absence of a child or other family member. Parents miss days of home responsibilities and work to stay with sick children overnight at the hospital.

I have enjoyed visiting with young men my age, often married with two children, sharing in our surprising similarities and comparing our different lifestyles.

Many struggles face both Amish patients and the providers who care for them in the health arena. As rural clinics and hospitals take on many uninsured patients, their revenue is compromised. As a result, cost of care increases and families are less able to afford the care in their community. One family traveled to Mexico for a cardiac bypass surgery to seek affordable care for the matriarch's worsening heart disease. This issue as well as many others plague not only the Amish but also the otherwise growing uninsured population in rural communities. I am learning much about the task and trials surrounding the endearing appearance of being a rural physician.

Challenged by community (mis)perceptions and health care access surrounding this community, I am looking forward to absorbing knowledge on rural doctoring. In the meantime, Amish country is certainly endearing itself to me.